Two New Mexico Counties: One’s Healthy, One’s Not. Why?

The healthiest county in New Mexico—indeed one of the healthiest counties anywhere in the country—is Los Alamos, ironically the birthplace of the world’s first atomic bomb.

According to the Robert Wood Johnson Foundation’s 2014 County Health Rankings and Roadmaps, Los Alamos, with one of the highest concentrations of PhDs and one of the highest median incomes in the nation, is not only wealthy and wise, but very healthy. In fact, it is a shining example of how education, income, and community—or the lack of—can shape our health, says Julie Willems Van Dijk, deputy director of the Rankings project.

New Mexico is a poor, rural state with a few small pockets of wealth. A 2012 analysis of state income disparities by the Center on Budget and Policy Priorities in Washington found that the gap between New Mexico’s rich and poor is, proportionately the widest in the nation. The County Health Rankings reflect the health consequences of that gap.

Los Alamos, the wealthiest county in New Mexico, began life in 1943 as a secret community built from the ground up by the U.S. Government. It was there, atop a steep, isolated plateau, that J. Robert Oppenheimer assembled an extraordinary group of scientists to build the atomic bomb. Once they succeeded, some returned home, but many stayed. The government continued to fund research there–including classified projects—and the secret town developed into the world-class science and technology center that is Los Alamos.

This thriving community has its own amateur symphony orchestra, an aquatic center, ice skating rink, two science museums, parks and top-notch schools. Today, the length and quality of life in Los Alamos are outstanding, according to the Rankings, which are based on a variety of measures that affect health, from education levels to tobacco use.

In Los Alamos County, premature deaths—that is, deaths before age 75—are among the lowest in the U.S. When asked about their health, only 9 percent of the 18,159 people in the county rated it poor or fair; almost 91 percent consider themselves comfortably healthy.

In stark contrast, Quay County, which stretches across the wide, empty plains of eastern New Mexico, is at the bottom of the state’s county health rankings, last in length and quality of life.

A poor, sparsely populated county, Quay’s rate of premature deaths is almost triple that of Los Alamos. A quarter of its 8,769 residents say they are in poor or fair health. “If I were talking to someone from Quay County, I would say people here are dying too early,” says Willems Van Dijk, an author of the County Health Rankings study. “And 25 percent are saying they feel like they’re in poor or fair health ...That’s one in four people who feels crummy, to put it plainly.”

Los Alamos began life with advantages that have only increased over time. The sprawling Los Alamos National Laboratory today employs thousands of scientists, researchers and support staff, and receives billions of dollars in government funding. The county’s unemployment rate is 3.5 percent. Only 4 percent of its children live in poverty. Almost 90 percent of its residents have graduated from high school.

In Quay, which is dotted with struggling farms and ranches, there are few industries and the unemployment rate is 6.9 percent. Even more troubling—37 percent of its children live in poverty. About 74 percent of its residents have graduated from high school.

Of all the factors that influence health, socioeconomic factors like these are given the most weight in the Rankings, Willems Van Dijk says.

The Rankings also look at healthy behaviors, followed by acces to quality clinical care and the physical environment. In Quay, for example, 28 percent of adults smoke, and 25 percent are obese. In Los Alamos, it’s a different story. Only 10 percent of its residents smoke, and 19 percent are obese (even in some of the healthiest U.S. counties the obesity rate is 25 percent). In Quay, 22 percent of residents are uninsured; in Los Alamos that figure is 5 percent.

When it comes to access to health care, in Quay, there is one primary care doctor for every 2,257 residents. In Los Alamos, the ratio is one doctor for every 588 residents.

Clearly, Van Dijk says, there is a correlation between socioeconomic status and health. “Poor people die earlier than wealthy people, she says. “So what can we do to improve this?”

A pragmatist, she concedes. “You’re not going to turn around poverty rates tomorrow.” But she insists, with even modest changes “you can ameliorate the effects of the poverty.”

Alida Brown, the coordinator of the Quay County Health Council, says that’s what the county is trying—small programs aimed at some of its big problems. Last July, Quay began a home visiting program it hopes will help its poor children get a good start in life. A trained worker begins regular visits to the parents before the child is even born, connecting the family to services, stressing prenatal care and nutrition.

“We know we have problems,” Brown says. “But there are plenty of other counties out there just like us. We’re the ones that are being left behind.”

Barbara Basler is a freelance writer living in Santa Fe, N.M. She has had a long career in journalism, with previous positions as an editor at the New York Times and AARP.